A review of duodenal metastases from squamous cell carcinoma of the cervix presenting as an upper gastrointestinal bleed

Abstract

Upper gastrointestinal bleeding due to duodenal metastases is extremely uncommon. Extra-pelvic spread of squamous cell carcinoma (SCC) of the cervix to the small bowel is rare with only 6 reported cases in the English literature since 1981(PubMed, Medline).We report the case of a 49-year-old woman who presented with upper-gastrointestinal bleeding two years after the diagnosis of SCC of the cervix. At esophagogastroduodenoscopy, there was a stricture in the second part of the duodenum which was biopsied for a suspected neoplastic lesion. Histologic and immunohistochemical examination showed a malignant lesion with characteristics identical to her original tumor in the cervix confirming the duodenal metastases.The clinical presentation of a 'malignant' upper-gastrointestinal bleed due to duodenal metastases from SCC of the cervix is unusual. Awareness of such infrequent patterns of metastases in cervical cancer confirmed by histopathological diagnosis is important for best practice therapeutic decisions in these patients.

Isolated jejunal metastasis in a patient with cervical cancer: A case report

“…In previous reports, metastasis of cervical cancer to the duodenum and spleen has been reported. [2][3][4] We herein report the first case of isolated jejunal metastases from early-stage cervical cancer, which was confirmed …”

“…Such spread is believed to occur commonly through the lymphatics, usually the para-aortic or mesenteric nodes to the bowel's serosa and less often via the blood stream or by peritoneal seeding. 3,4 Only seven cases have been reported for SCC of the cervix with documented metastases to the small bowel, 3 and there is only one published case report of a cervical cancer metastasizing to the jejunum. 9 Misonou et al 9 reported a case with stage IA cervical cancer recurring 13 years after hysterectomy with multiple metastases to the jejunum, which caused small intestinal perforation.…”

Fisetin Inhibits Migration and Invasion of Human Cervical Cancer Cells by Down-Regulating Urokinase Plasminogen Activator Expression through Suppressing the p38 MAPK-Dependent NF-κB Signaling Pathway

“…Although cervical cancer death rates have been decreasing, the recurrence and metastasis of cervical carcinoma to other sites such as the lymph nodes [2,3], lungs [4,5], bones [6,7], liver [8], and bowels [9] are critical factors contributing to mortality in cervical cancer patients. Therefore, apart from surgery and the destruction of cervical cancer cells by medication, inhibiting metastasis is an auxiliary strategy for curing patients of cancers.…”

Gastric and duodenal squamous cell carcinoma: metastatic or primary?

“…Kanthan et al . adopted CK5, p63 and p16 as immunohistochemical markers to confirm the diagnosis of SCC of the cervix metastatic to the duodenum [15]. Strikingly, Gevaert et al .…”